背景:基于在线正念的认知疗法(eMBCT)已被证明可以减轻癌症患者的心理困扰。然而,这一人群报告说,缺乏支持和异步通信是eMBCT的障碍,导致比面对面MBCT更高的不依从率。使用共同创造过程,我们开发了两种格式的eMBCT:组,混合(治疗师指导小组和个人在线会议的组合)和个人,无指导的(个人,仅限无指导的在线会话)。Group,混合eMBCT提供同行支持和指导,而个人,无指导的eMBCT提供了灵活性和大规模实施的可能性。
目的:这项非随机可行性研究的目的是评估小组的可行性,混合和个体,无指导的eMBCT干预。
方法:参与者是癌症患者,他们在组间进行选择,混合和个体,无引导的eMBCT。两种干预条件都遵循相同的8周eMBCT计划,包括介绍性会议和无声日(共10个会议)。所有个人会议,无指导的eMBCT通过Minddistrict平台发生,而集团,混合eMBCT包括由正念老师指导的3次在线视频会议和通过Minddistrict的5次会议。我们通过评估参与者的可接受性来定量和定性评估干预的可行性。此外,我们通过观察干预前和干预后参与者完成问卷的数量来评估有限的疗效.
结果:我们在每种eMBCT条件下纳入了12名参与者。小组参与者,完成混合eMBCT,平均而言,10届会议的9.7,与个人平均8.3次相比,无引导的eMBCT(不包括退出)。在24名参与者中,13人(54%)同意接受采访(5人无指导,8人混合采访)。这两种情况的参与者都报告了积极的经历,包括不必旅行的便利性以及选择何时何地参加的灵活性。然而,在参与的障碍中,小组的参与者,混合条件报告了更多小组会议的偏好,和个体的参与者,无指导条件报告缺乏指导。此外,对于团体来说,混合条件,所有结局指标的效应大小都很小(对冲g范围=0.01-0.36),除了疲劳,具有中等效应大小(Hedgesg=0.57)。对于个人来说,无导向条件,所有结果测量的效应大小都很小(对冲g范围=0.24-0.46),除了正念技能(对冲g=0.52)和参与干预(对冲g=1.53)。
结论:这项研究的参与者对小组有积极的体验,混合和个体,无引导的eMBCT。根据这项研究的结果,在进行全面随机对照试验之前,我们将调整干预措施,以评估有效性;我们将在组中增加1组会议,使用Zoom作为小组会议平台的混合eMBCT;我们将向参与者发送提醒以完成问卷。
背景:ClinicalTrials.govNCT05336916;https://clinicaltrials.gov/ct2/show/NCT05336916。
BACKGROUND: Online mindfulness based cognitive therapy (eMBCT) has been shown to reduce psychological distress in people with cancer. However, this population has reported lack of support and asynchronous communication as barriers to eMBCT, resulting in higher nonadherence rates than with face-to-face MBCT. Using a co-creation process, we developed 2 formats of eMBCT: group, blended (combination of therapist-guided group and individual online sessions) and individual, unguided (individual, unguided online sessions only). Group, blended eMBCT offers peer support and guidance, whereas individual, unguided eMBCT offers flexibility and the possibility of large-scale implementation.
OBJECTIVE: The objective of this nonrandomized feasibility study was to assess aspects of feasibility of the group, blended and individual, unguided eMBCT interventions.
METHODS: Participants were people with cancer who chose between group, blended and individual, unguided eMBCT. Both intervention conditions followed the same 8-week eMBCT program, including an introductory session and a silent day (10 sessions total). All sessions for individual, unguided eMBCT occurred via the platform Minddistrict, whereas group, blended eMBCT consisted of 3 online videoconference sessions guided by a mindfulness teacher and 5 sessions via Minddistrict. We assessed the feasibility of the intervention quantitatively and qualitatively by evaluating its acceptability among participants. Additionally, we assessed limited efficacy by looking at the number of questionnaires participants completed pre- and postintervention.
RESULTS: We included 12 participants for each eMBCT condition. Participants in group, blended eMBCT completed, on average, 9.7 of 10 sessions, compared with an average 8.3 sessions for individual, unguided eMBCT (excluding dropouts). Of the 24 participants, 13 (54%) agreed to be interviewed (5 unguided and 8 blended). Participants in both conditions reported positive experiences, including the convenience of not having to travel and the flexibility to choose when and where to participate. However, among the barriers for participation, participants in the group, blended condition reported a preference for more group sessions, and participants in the individual, unguided condition reported a lack of guidance. Additionally, for the group, blended condition, the effect sizes were small for all outcome measures (Hedges g range=0.01-0.36), except for fatigue, which had a moderate effect size (Hedges g=0.57). For the individual, unguided condition, the effect sizes were small for all outcome measures (Hedges g range=0.24-0.46), except for mindfulness skills (Hedges g=0.52) and engagement with the intervention (Hedges g=1.53).
CONCLUSIONS: Participants in this study had a positive experience with group, blended and individual, unguided eMBCT. Based on the results from this study, we will adjust the intervention prior to conducting a full-scale randomized controlled trial to evaluate effectiveness; we will add 1 group session to the group, blended eMBCT using Zoom as the platform for the group sessions; and we will send reminders to participants to complete questionnaires.
BACKGROUND: ClinicalTrials.gov NCT05336916; https://clinicaltrials.gov/ct2/show/NCT05336916.